Oncologic emergencies

This article focuses on the common emergencies that are the first sign of cancer in a previously well child and those occurring from treatment or at the time of relapse. Space-occupying lesions include compression of the superior vena cava or airway that may lead to respiratory or circulatory failure, spinal cord compression (which carries the risk of irreversible paraplegia or urinary incontinence), and brain tumors that may present with life-threatening raised intracranial pressure. Hematologic emergencies include bone marrow failure with anemia and thrombocytopenia, hyperleukocytosis with the high risk of thrombotic events, and coagulation abnormalities. Life-threatening metabolic abnormalities must be considered in children with leukemia and lymphoma at the time of diagnosis. Prompt recognition and treatment of these emergencies may save the life of the child with cancer.